All issues > Volume 53(2); 2010

Original Article

Korean J Pediatr. 2010;53(2):210-214. Published online February 15, 2010.

Ototoxicity in children receiving cisplatin chemotherapy

Hee Jin HJ Jang¹, Hyung Rae HR Cho¹, Jae Hee JH Lee², Kun Yuk KY Bae¹, Jong Jin JJ Seo¹, Hyung Nam HN Moon¹, Ho Joon HJ Im¹

¹Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
²Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea

Correspondence Ho Joon HJ Im ,Tel: +82.2-3010-3371, Fax: +82.2-473-3725, Email: hojim@amc.seoul.kr

Abstract

Purpose
: Cisplatin is highly effective for the treatment of solid tumors in children. However, the clinical use of cisplatin is limited by its ototoxicity. The aim of this study was to evaluate the ototoxicity in children treated with cisplatin.
Methods
: We performed a single institution retrospective analysis of pediatric oncology patients who received cisplatin therapy between January 2001 and January 2008. Thirty-seven patients with sufficient medical and audiologic data were included in this study.
Results
: The median age at the time of diagnosis was 10.7 (range 3.8–16.7) years. There were 16 males and 21 females. The underlying diseases were osteosarcoma (15 cases), medulloblastoma (14 cases), germ cell tumors (7 cases), and hepatoblastoma (1 case). The median individual dose was 100 mg/m2/cycle (56-200). The median cumulative dose was 480 mg/m2 (200-1,490). Sixteen patients (43%) received cranial radiotherapy. Of the 37 patients, 17 developed hearing loss, leading to an overall incidence of 46%. Logistic regression showed that age at treatment (P=0.04) and cumulative dose of cisplatin (P=0.005) were the significant risk factors in predicting hearing loss in children treated with cisplatin. In all the patients who had hearing loss, there was neither improvement nor aggravation during the follow-up (3–68 months).
Conclusion
: The cumulative dose of cisplatin (>500 mg/m2) and younger age at treatment (<12 years) were 2 most important risk factors for ototoxicity in patients treated with cisplatin. Serial audiometric evaluations are needed in the patients with risk factors during and after cisplatin treatment.

Keywords :Cisplatin, Adverse effects, Hearing loss, Children, Adolescent